“Non-medical switching” is a practice that commercial insurance companies use to change coverage or premiums at any point during year. Even when the insured person is already receiving a specific drug or treatment, the insurer has the option change coverage for that drug or treatment.

A Pennsylvania bill introduced by Rep. Donna Oberlander seeks to prohibit commercial health insurers from making coverage changes during the policy year that deny or increase the cost of a treatment, service or prescription that a patient is already receiving. The bill – House Bill 853 – was introduced on March 18, 2019 and has been referred to the House Consumer Affairs Committee.

The Pennsylvania Medical Society (PAMED) supports HB 853. We are part of the Pennsylvanians for Fair Health Coverage coalition, a group of health care organizations in the state that have joined together to help ensure that treatment decisions made between physicians and patients are protected.

For Pennsylvanians who are living with serious chronic health conditions, coverage changes allowed by non-medical switching can have a devastating impact on a family’s health and finances. We believe in making coverage fair – If Pennsylvania families can’t change plans during the policy year, insurers shouldn’t be able to change coverage for treatments and services the patient is receiving.

The bill would still allow insurers to remove unsafe treatments and services from coverage. And, insurers could still make changes for patients who are not already on a certain treatment or service.

Additional Resources

You can learn more about the efforts of the Pennsylvanians for Fair Health Coverage coalition at faircoveragepa.org.